SILVER SPRING, MD, November 17, 2011—This week, the city of Milwaukee set off a firestorm of controversy across the country with new posters its Health Department unveiled in its campaign to decrease the practice of bed-sharing. The ads show a baby in bed next to a butcher knife, with the claim that sleeping with a baby is just as dangerous. The ads will be displayed on the sides of buses and in other publicly visible spots across the city.
On its website, the city’s Health Department states that, “20% of infant mortality is attributable to a combination of Sudden Infant Death Syndrome (SIDS), and Sudden Unexplained Death in infancy (SUDI). Of these deaths the majority die in an unsafe sleep environment.” The city’s warning against bed-sharing is based on a 2011 policy statement from the American Academy of Pediatrics (AAP), which says there is a substantial increase the risk of SIDS or suffocation while bed-sharing.
Milwaukee’s ad campaign is designed to shock. The city’s health department wants to raise awareness and start a discussion about what are considered safe infant sleep conditions, but does it go too far? According to Attachment Parenting International (API), 42% of parents say they bed-share at least part of the time. One study published in Archives of Pediatrics and Adolescent Medicine, found that the number of parents bed-sharing with their infant doubled during the 1990s, especially among breastfeeding mothers. The Center for Disease Control and Prevention, as well as the National Institutes of Health agree with the AAP that bed-sharing poses inherent suffocation risks.
Proponents of bed-sharing say that the practice of babies sleeping apart from their parents is relatively new. They point to other countries and cultures where bed-sharing is a regular practice, and where lower infant mortality rates validate the claim that it reduces the risk of SIDS. However, study after study conducted by the medical community shows otherwise.
Other reasons given for bed-sharing are to strength the bond between parent and child, and to be there to provide night time needs, whether for food or comfort. One of the reasons provided for bed-sharing – the convenience to a nursing mother of having her child in arm’s reach to nurse in bed so that she can get more rest – makes sense from a common sense point of view, especially, to the sleep-deprived nursing mother. However, the AAP policy specifically cautions against having any infant younger than 3 months – the time when parents tend to feel the most sleep deprived – bed-share.
Why is bed-sharing not advised? For the same reason that current recommendations say you shouldn’t put blankets, stuffed animals or bumpers in cribs. The soft bedding and pillows provide a suffocation hazard, as do soft surfaces like sofas or waterbeds. Young children do not have the dexterity or coordination to untangle themselves or remove barriers to their breathing. There have also been cases of people rolling onto their infant in their sleep, resulting in suffocation. So, while the general AAP guideline is not to bed-share, they further caution against bed-sharing with people on medication, as they are harder to wake and might roll onto an infant and not wake until it’s too late.
So what’s a parent to do? If you find the arguments of the attachment parenting groups compelling and want to reap the benefits of having your baby close, but you still have concerns about safety, try co-sleeping instead of bed-sharing. API distinguishes between bed-sharing and co-sleeping. In co-sleeping, babies sleep on a separate surface from their parents, but nearby, whereas bed-sharing is just that, placing an infant in a bed with you.
Be careful when shopping, not all infant co-sleeping solutions are equal. The AAP statement goes on to say that devices that claim to make bed-sharing safe are unsafe as well. In fact, several such devices have been recalled by the U.S. Consumer Product Safety Commission.
Proponents of co-sleeping say that it creates a bond between parent and child, makes nighttime feedings easier on nursing mothers, and helps meet infants’ other needs of comfort and reassurance that come from being near a parent. They argue the number of confirmed deaths from suffocating in an adult bed is so small that it’s negligible. The AAP asks whether, even if the number is low, you, as a parent, want to take that chance. Ultimately, the choice is yours.
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